The releasor authorizes his/her employer to release employment references including, but limited to, his/her employment history and wages and any information which may be requested relative to his/her employment, employment applications, and other related matters, and to furnish copies of any and all records which the employer may have regarding his/her employment.
Release Of Information For Therapist In Chicago
Category:
State:
Multi-State
City:
Chicago
Control #:
US-00458
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
Request Online Request medical records with our new online tool. Your records are delivered right to you — no need to go and pick them up. Choose from Electronic or Mail delivery. Appropriate fees may apply (State of Illinois Copying Fees Adjustments).
You can submit your medical records request via email or mail to the hospital from which you're seeking the records. If you send via mail, please address the envelope to the attention of the Health Information Management Department at the hospital. You also can stop in and drop off your request in person.
In Illinois you have the right to: See and get a copy of your medical record. a copy of it within 30 days after they receive your request.
Check their website: Information about how to get your health record may be found under the Contact Us section of a provider's website. It may direct you to an online portal, a phone number, an email address, or a form. Phone or visit: You can also call or visit your provider and ask them how to get your health record.
FOIA is the state Freedom of Information Act. Under the Illinois Freedom of Information Act (5 ILCS 140), records in the possession of public agencies may be accessed by the public upon written request.
